Provider Demographics
NPI:1598860447
Name:DEPASQUALE, DAVID JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:DEPASQUALE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MAIN STREET
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LUNENBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01462
Mailing Address - Country:US
Mailing Address - Phone:978-582-6199
Mailing Address - Fax:978-582-6199
Practice Address - Street 1:ONE MAIN STREET
Practice Address - Street 2:SUITE 207
Practice Address - City:LUNENBURG
Practice Address - State:MA
Practice Address - Zip Code:01462
Practice Address - Country:US
Practice Address - Phone:978-582-6199
Practice Address - Fax:978-582-6199
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMASS18072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist